Enhanced Problem-solving Therapy and HIV Engagement Support to Improve Perinatal Mental Health and HIV Outcomes in Malawi: A Randomized Controlled Trial

What this Trial Is About

Researchers are evaluating the Enhanced Friendship Bench intervention to improve perinatal depression, HIV care engagement, and infant health outcomes among pregnant women with HIV and depression in Malawi. This fully powered randomized controlled trial aims to confirm the intervention's effectiveness, study how it works, and gather important data to help apply the findings in real-world settings. The study follows up on a pilot trial that showed promising results for improving mental health and HIV care during and after pregnancy. Participants will receive either the Enhanced Friendship Bench intervention or enhanced usual care. The Enhanced Friendship Bench includes problem-solving therapy with four prenatal and two postnatal counseling sessions, two social support sessions, and monthly home visits for ART delivery and counseling during the third trimester and first three months postpartum. The comparison group will receive usual outpatient care enhanced with mental health evaluations, brief counseling, education about mental health, and referral support when needed. Throughout the study, participants will be monitored for changes in depressive symptoms and HIV care retention six months after giving birth. Infant growth measurements will also be taken at six months postpartum, including height-for-age, weight-for-age, and weight-for-height. Additional assessments include depression remission and HIV viral suppression up to twelve months postpartum. The study uses double-masked methods and randomizes participants to either group, with ongoing evaluations to track health outcomes and treatment engagement over time.

Enhanced Problem-solving Therapy and HIV Engagement Support to Improve Perinatal Mental Health & HIV Outcomes in Malawi